Paediatric Infectious Diseases Research Group, St George's University of London, London, UK.
Department of Infection and Immunity, Monash Children's, Monash Medical Centre, Clayton, Australia.
Arch Dis Child Fetal Neonatal Ed. 2018 Sep;103(5):F474-F478. doi: 10.1136/archdischild-2017-313238. Epub 2017 Oct 26.
To define the susceptibilities of the common causative pathogens of neonatal sepsis in the UK.
Retrospective analysis of the prospectively collected neonIN infection surveillance network data between 2005 and 2014.
30 neonatal units in the UK.
Newborns admitted to participating neonatal units who return a positive blood, cerebrospinal fluid or urine culture and are treated with at least 5 days of appropriate antibiotics.
1568 isolates with recorded antimicrobial data were collected including 328 early-onset sepsis (EOS) isolates and 1240 late-onset sepsis (LOS) isolates. The majority of EOS pathogens (>92%) were susceptible to the four empirical commonly used antimicrobial combinations (eg, 93% for benzylpenicillin/gentamicin), while LOS pathogens demonstrated higher levels of resistance (eg, 89% for flucloxacillin/gentamicin). Among infants<1500 g and <32 weeks gestation, an amoxicillin/gentamicin combination demonstrated a trend towards improved coverage of EOS isolates than benzylpenicillin/gentamicin (93% vs 86%, p=0.211).
This analysis provides insights into the patterns of antimicrobial resistance among UK neonatal pathogens. These data will inform areas of future research and can be used to update national evidence-based guidelines on antimicrobial usage.
确定英国新生儿败血症常见病原体的敏感性。
对 2005 年至 2014 年期间前瞻性收集的 neonIN 感染监测网络数据进行回顾性分析。
英国 30 个新生儿病房。
入住参与新生儿病房并返回阳性血、脑脊液或尿液培养且接受至少 5 天适当抗生素治疗的新生儿。
共收集了 1568 株有记录抗菌药物数据的分离株，包括 328 株早发型败血症（EOS）分离株和 1240 株晚发型败血症（LOS）分离株。大多数 EOS 病原体（>92%）对四种经验性常用抗菌药物组合敏感（例如，苯唑西林/庆大霉素为 93%），而 LOS 病原体的耐药率更高（例如，氟氯西林/庆大霉素为 89%）。对于体重<1500g 和<32 周的婴儿，阿莫西林/庆大霉素组合对 EOS 分离株的覆盖范围较苯唑西林/庆大霉素有改善趋势（93%对 86%，p=0.211）。
该分析提供了英国新生儿病原体中抗菌药物耐药模式的见解。这些数据将为未来的研究领域提供信息，并可用于更新国家抗菌药物使用循证指南。
